Pain in the thigh is an unpleasant or painful sensation caused by a pathological process in the bones, soft tissues, nerves, and vessels of the thigh. It can be constant, intermittent, short-term, weak, intense, dull, or acute. Often combined with edema, dysfunction of the limb. It is caused by trauma, inflammatory, degenerative, tumor diseases, and other factors. The etiology of pain is established based on complaints, examination data, radiography, CT, MRI, and other studies. Until the cause is clarified, rest is shown, sometimes analgesics can be taken.
Hip bruising occurs upon impact or fall, manifested by moderate local pain. At first, the pain is sharp, then - dull, aching, aggravated by palpation and movements. Due to the large array of soft tissues, pronounced edema often develops. Possible bruising. The function of the limb is usually limited slightly, the support is preserved.
A hematoma is also formed after bumps and falls, in its manifestations it resembles a bruise. It differs from a bruise in the bursting or pressing nature of pain, the formation of dense local edema, in the zone of which, after a while, a fluctuation area appears. With deeply located hematomas, the edema is nonspecific, fluctuation may be absent. Hematoma can be suspected of a significant increase in swelling in the early days or its persistence for a long time.
Damage to the tendon of the quadriceps muscle is observed in athletes, but less often develops in everyday life. It is characterized by acute pain along the anterior surface of the thigh, just above the knee joint, sometimes with a crack at the time of injury. Subsequently, the pain subsides but remains quite intense. In the area of damage, pain, and swelling of soft tissues, a defect at the site of the rupture is revealed. With a complete rupture, support and self-straightening of the lower leg are impossible, with an incomplete one, it is difficult.
The cause of a diaphyseal fracture of the femur is high-energy impacts: falls from a height, road, and industrial injuries. Damage is accompanied by unbearable explosive pain. In the future, the pain is very intense, aggravated by attempts to move, palpation, and passive shifting of the limb. The thigh is edematous and deformed. The leg is shortened. Crepitus and pathological mobility are revealed. The general condition is disturbed, and traumatic shock is possible.
A pathological fracture of the femoral diaphysis can be diagnosed with bone cysts, tumors, and some hereditary and infectious diseases. It is characterized by mild symptoms. Pain is mild or moderate. Displacement, pathological mobility, and bone crunch are absent, which is why the injury is often mistaken for a bruise. Distinctive features of a pathological fracture are the long-term persistence of symptoms, and the presence of previous pain during exercise or at rest.
Myositis of the thigh muscles occurs after an unusual physical activity: a long walk or run, the first training after a long break. It is characterized by an aching pain in the projection of the affected muscle or muscle group. There is an increase in pain on palpation and muscle tension. When palpating, diffuse thickening of the muscle is determined, and slight edema and slight local hyperthermia are possible.
Tendonitis of the tendon of the quadriceps is usually found in active people over 40 years of age, manifested by vague, non-intense pulling pains in the lower sections of the anterior side of the thigh. Pain is aggravated by unbending the leg. With tendonitis of the biceps tendon, which is characteristic of runners, the pain is localized deep in the buttock, spreads behind the thigh, and intensifies during running, especially when accelerating. Subsequently, the pain becomes prolonged, constant, and occurs after a slight load, at rest, and night.
Pain on the outer surface of the thigh is sometimes accompanied by aseptic arthritis of the hip joint of various etiologies (reactive, allergic, post-traumatic). The pains are aching, dull, non-localized, accompanied by soreness in the groin and buttocks, limitation of movement, and difficulty walking.
Pain in the hip
Periostitis of the femur develops infrequently, as a rule, it becomes the result of injuries (bruises, fractures) or purulent lesions (deep infected wounds, abscesses, cellulitis, arthritis). In the first case, the process is aseptic, accompanied by moderate pain, aggravated by palpation. There is a slight swelling. The general condition is not broken.
Sometimes there is a serious post-traumatic periostitis, characterized by a significant accumulation of fluid under the periosteum. Pathology is manifested by moderate arching pains, swelling, and deformity. With purulent inflammation of the periosteum, acute onset is observed with intense jerking and throbbing pains. Local hyperemia, significant swelling of the segment, fever, chills, and fever are detected.
The femur is one of the most common sites for hematogenous osteomyelitis. Inflammation of the bone develops in childhood, often in the background of a minor injury or after an acute infection. It proceeds with a sharp increase in temperature, fever, chills, and delirium. A day after the onset of hyperthermia, intense localized deep pain in the thigh occurs. The pain grows, and becomes unbearable, forcing the patient to freeze in bed.
There is a local form of hematogenous osteomyelitis, in which the pain syndrome is less pronounced, and the general condition is slightly disturbed. In some cases, there is a severe hurricane course of the disease with a predominance of general symptoms. Post-traumatic and postoperative osteomyelitis is also manifested by pain, edema, hyperemia, and general disorders, but the pain appears against the background of suppuration of an open fracture or postoperative wound, progresses more slowly, and does not reach the degree of unbearable.
Pain in the thigh is noted with purulent lesions of soft tissue structures. Initially, it has a bursting or pressing character. The intensity of the pain syndrome increases rapidly, the pains become pulsating, tearing, twitching, sharply limiting movements, disrupting night sleep. Puffiness and an increase in local temperature are revealed. The severity of general manifestations (hyperthermia, fever, symptoms of intoxication) depends on the prevalence of the purulent process. Pain is caused by:
From the foci in the soft tissues, the infection can spread through the lymphatic vessels. The manifestation of reticular lymphangitis is evidenced by increased pain, worsening of the general condition, and the appearance of a marble pattern around the primary inflammatory focus. With stem lymphangitis, a longitudinal strip appears on the thigh, along which pain on palpation, edema, hyperemia, and cord-like tissue thickening are determined. When deep vessels are affected, the bands on the limbs are not detected, and there is a rapidly growing arching pain, and lymphedema of the underlying sections.
With phlebitis and thrombophlebitis of the superficial veins of the thigh, which develop against the background of infectious lesions or varicose veins, rapidly progressing pain along the vein is found. Pain increases with walking, usually localized in the lower third of the segment. Phlebitis and thrombophlebitis of deep veins are manifested by constant increasing pain, swelling, general hyperthermia, and milky-white color of the skin of the limb.
A special form of vein damage is postpartum thrombophlebitis, which occurs in the first weeks after childbirth. Intense pain on the inside of the thigh is observed with inflammation of the great saphenous vein, combined with swelling, and deterioration of the general condition. When the deep femoral veins are involved, unbearable sharp pains are noted along the anterior-inner surface of the thigh, significant swelling, pallor of the skin of the limb, and fever.
For benign tumors of the femur, slow growth and a long, often long-term course are typical. Osteomas and chondromas are manifested by slight transient unclear pains, with chondromas in children, deformations, and shortening of the limb are possible. With osteoid osteomas, pain is intense and sharp. The growth of neoplasia is accompanied by increased pain and the appearance of palpable formations of bone density.
The most common malignant tumors of the hip include osteosarcoma, chondrosarcoma, and Ewing's sarcoma. Chondrosarcomas are usually localized in the upper part of the bone, osteogenic sarcomas - in the upper or lower, and Ewing's sarcomas - in the lower. Pain with such neoplasms is initially dull, unclear, quickly intensifies, and becomes unbearable, combined with the appearance of a venous pattern, deformity, weight loss, and general weakness.
Hip pain is often caused by neurological diseases. Distinctive features of such pain are shooting, burning, shooting, or penetrating in nature (some patients compare the sensations with a “dagger strike”), a combination with paresthesia, weakening of muscle strength, and sensitivity disorders. Pain in the thigh area provokes the following pathologies:
Sometimes pain in the thigh is provoked by diseases of neighboring structures or distant organs, and mental disorders. Possible causes of pain may include:
The examination is usually carried out by orthopedic traumatologists. With purulent processes, patients are examined by a surgeon, with neurological pathology - by a neurologist. In the initial stage, the doctor finds out the anamnesis of life and disease and conducts an external examination. The following additional studies are assigned:
In case of traumatic injuries, they provide the rest of the limb. In case of fractures, the leg is fixed using two splints: the inner one from the foot to the groin, and the outer one to the armpit. Cold is applied to the leg, in case of severe injuries, painkillers are administered, and according to indications, anti-shock measures are taken. The severity of the symptoms of myositis and tendonitis is reduced with the help of anti-inflammatory, analgesic gels and ointments. Sharp pains, significant edema, and violations of the general condition are the reason for an immediate visit to the doctor.
Patients with fractures undergo blockades and fix the thigh with skeletal traction, which, after the appearance of clinical and radiological signs of adhesion, is replaced with a plaster cast. The tactics of treatment for other lesions are determined based on the nature of the disease. Conservative treatment for most hip pathologies includes:
The listed activities are supplemented with massage, sometimes with manual therapy, and taping. For purulent diseases, antibiotics are prescribed, for inflammatory pathologies - NSAIDs, for neurological lesions, blockades are performed.
Hip taping
Operations are indicated when conservative therapy is ineffective, to reduce the duration of recovery, early activation of the patient, and reduce the risk of complications. Taking into account the characteristics of the lesion, the following are carried out:
During the postoperative period, antibacterial and painkillers are used, and complex rehabilitation measures are carried out. For oncological diseases, radiation therapy, and chemotherapy is prescribed.